Morton's neuroma: who, when and how contributed to its description and treatment?

Abstract

Purpose: The interdigital nerve neuroma of the forefoot is commonly known as Morton's Neuroma. Many authors have described and treated this condition before and after Morton. This study aims to investigate the past scientific literature to better understand what comprehension and treatments have been used to master this pathology.

Methods: Historical and modern scientific accounts were searched for descriptions of interdigital nerve neuroma or metatarsalgia (as some authors described it) to have a thorough overview of the subject. The scientific literature was searched to highlight the evolution of the nomenclature and to summarise historical and current treatments, especially conservative ones.

Results: Influential authors described the interdigital nerve neuroma and its symptoms. Durlacher, the King's podiatrist in England in the 1800s, was the first to understand that this was a neuralgic affection; with his practical approach, he treated the Neuroma using pressure-relieving footwear. The first anatomical description should be credited to the Italian anatomist Civinini. Morton, the American Civil War surgeon, was the first to understand the aetiology of pain better and the first to propose a surgical treatment to relieve symptoms. Tubby, the British alpine climber, linguist, archaeologist and orthopaedic surgeon, observed a nodular mass on the third common digital nerve and proposed surgical treatment with resection of the metatarso-phalangeal joint.

Conclusion: the use of a term widely accepted and recognised by all its users with a precise meaning and symbolisation makes it easily understandable and lasting. Also, if it is known that what is called Morton's neuroma is not a neuroma but a benign perineural fibrosis of a common plantar digital nerve, the use of the terminology Morton's neuroma is still universally accepted and recognised.